Abstract
BackgroundPoverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme.MethodsWe employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty.ResultsCommunity defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community.ConclusionThe in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care.
Highlights
IntroductionThe quantitative means testing approach, related to a more positivist knowledge paradigm has been used to determine poverty levels based on identified income or consumption expenditures
In this paper we explore in more depth the qualitative and relativist indicators of poverty revealed by the participatory wealth ranking process
Participatory wealth ranking has the advantage of providing qualitative details and relative perspectives, which are otherwise missing in quantitative measures such as means testing and proxy means testing
Summary
The quantitative means testing approach, related to a more positivist knowledge paradigm has been used to determine poverty levels based on identified income or consumption expenditures. This approach premises that to be poor is to be lacking in some material worth, to be deficient in some way, or to fail to meet a ‘minimum requirement’ of something [1,2]. In contrast the qualitative approach premises that poverty is a social construct whose understanding requires a contextual and relativist approach to knowledge [3,4,5]. Mixed methods have emerged exploring both qualitative-quantitative dimensions of poverty to provide a comprehensive view on poverty [8,9,10]
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